Augmentative and alternative communication decision making for children with severely unintelligible speech

Abstract

Decision making in augmentative and alternative communication (AAC) is particularly difficult for children who have some functional speech. This is in part because there is no measure of speech intelligibility in children that is sensitive to partner familiarity and semantic context, factors that have been shown to greatly impact the comprehensibility of severely impaired speech. This paper describes the development and clinical use of a measure of functional speech comprehensibility for children. The author presents four case studies of children with severe speech impairments who were referred for AAC evaluation. These case studies demonstrate the role of such a measurement tool in AAC decision making for the following purposes: (1) to resolve team conflicts about speech versus alternative strategies, (2) to demonstrate the benefit of speech supplementation strategies for some children for whom AAC equipment may be inappropriate at this time, and (3) to demonstrate the limitations of speech supplementation for some children who will need alternative approaches as they grow more independent.

• augmentative and alternative communication (AAC)
• case study
• children
• communication partner
• comprehensibility
• dysarthria
• intelligibility
• speech supplementation